HomeMy WebLinkAboutF2021-0196 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
0 / 2 City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # FX Fire Sprinkler r Fire Alarm i— Fire Misc
1. Project Address (Not mailing address) Floor Suite No
1405 KEEL DR
Tenant Name LU RESIDENCE # Units
I
2. Description of Work
FIRE SPRINKLERS
Use
38 HEADS
Valuation $ 3800
Extg Sq Ft F_New/Added Sq Ft F__ Total Sq Ft r
# Stories 1
jX New F_Add j— Alter F_Demo
Check Appropriate Box for Applicant/Notification
Infn►mafinn
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F
Zip F_ Telephoned
F 4. Architect/Designer's Name Last
First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State F_
Zip F_ Telephoned
F_ 5. Engineer's Name Last
First 7— Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip � Telephoned
6. Contractor's Name Last CASEY
First MONTI Lic. No. 876004 Class C-16
Contractors Address
Contractor's E-mail Address
1101 KINGSTON DR
FIREPROOFMC@GMAIL.COM
City LA HABRA
State CA
Zip 90631 Telephone 714 476-5370
OFFICE USE ONLY
PERMIT NO. ��� d I1,0
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
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PLAN CHECK FEE $